| NPI | 1851598072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301507948) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036.125638) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-10-10 |